DOJ Recovers $2.9 Billion in Fraud in 2024

The Department of Justice (DOJ) announced that the agency recovered $2.9 billion in resolutions to federal False Claims Act allegations for 2024 (fiscal year ending September 30).  This is a slight increase from the historic $2.7 billion recovered in fiscal year 2023. Office of Public Affairs | False Claims Act Settlements and Judgments Exceed $2.9B … Read more

CMS Releases Home Health Final Rule 2025

On November 1 the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year 2025 Home Health Prospective Payment System (HH PPS) final rule, which updates Medicare payment policies and rates for Home Health Agencies.  Unlike other Medicare provider types that have PPS rule updates corresponding to the federal fiscal year (10/1), home health … Read more

Federal Judge Key Ruling on False Claims Act

On September 30, US District Judge Kathryn Kimball Mizelle from the Middle District of Florida ruled in a landmark decision that the qui tam provision of the federal False Claims Act (FCA) is unconstitutional. This ruling could have significant impact on whistleblower (Qui Tam) actions filed against healthcare providers, particularly home health and hospice (most … Read more

Nursing Assistants = Supply Shortage

Nursing assistants are anticipated to experience the largest projected shortfall among all healthcare occupations analyzed, with an expected national shortage exceeding 73,000 assistants by 2028. This projection is based on a report by Mercer, which also predicts a nationwide deficit of over 100,000 healthcare workers by the same year. The demand for nursing assistants is … Read more

Exploring Age-Friendly Healthcare Programs

The Accreditation Commission for Health Care, Inc. (ACHC) has launched two new specialty credentials for organizations providing home care and/or hospice.  These programs are in line with the Age-Friendly Health Systems (Care) programs and initiatives started by The John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI), in partnership with the American Hospital Association (AHA) and … Read more

TEAM Model and Post-Acute Care

The mandatory Transforming Episode Accountability Model (TEAM) will advance CMS prior work on value-based care models, including bundled care initiatives. The TEAM model (participation) will be mandatory for selected hospitals and participation “optional” for post-acute care providers. Transforming Episode Accountability Model (TEAM) | CMS The Transforming Episode Accountability Model (TEAM) is set to be a … Read more

Senior Housing and Care M&A at Record Level

Mergers and acquisitions activity in the seniors housing and care sector set a new quarterly record with 183 publicly announced transactions in the second quarter of 2024, as reported by LevinPro LTC. This represents a 21% increase over the 151 transactions from the first quarter of 2024, and a 49% rise compared to the 123 … Read more

Private Equity Investment in Nursing Home Sector Generates Regulatory Scrutiny

Private equity investment in the nursing home and assisted living sector (other post-acute as well) continues to be a focus of regulatory activity in Congress.  This is despite private equity investment in the nursing home sector to be involve about 5% of facilities. Home health has seen an increasing investment interest as well from private … Read more

Senior Living Rate Increases are Slowing: Revenue Diversification Offers Opportunities

As inflation has cooled, senior living rate increases are slowing. Growing occupancy has been a function of incentives, particularly rate concessions and discounts.  The greatest use of discounting is in independent living, particularly Life Plan organizations/CCRCs. And, while rate increases shift lower, revenue does as well.  Unfortunately, operating cost increases are not subsiding, especially with … Read more

Tip-Toeing Through the (Healthcare)Econ Tulips

Bunches (pun intended) of economic data the past two weeks and as readers can tell from the title, I’m getting a little “punchy” with all the data. Anyone about my age should recall a celebrity known as Tiny Tim. His fame, short-lived as it should have been, including playing the Ukulele and signing in a … Read more